Three's a Crowd

There has to be some way around the awkward CI-student-patient triangle. Does everyone know what I'm talking about? As a student following my CI's every footstep, I constantly feel like I'm encroaching on some private interaction between PT and patient. Sometimes it results in a hilarious interaction (i.e. a patient telling me he feels like he's at a recital), but at other times I feel like a more serious nuisance.

The awkwardness seems to be worst with the patients who are basically independent with their exercise programs. Realistically, these patients could probably make it through their therapy sessions with minimal input from their PTs. They surely don't need two people watching them, critiquing their form on every exercise.

On a more serious note, yesterday I ran into a situation where a patient was hesitant to disclose a part of her medical history, and I was afraid it was because I was in the room. I recognized that she was uneasy, but I didn't really know what to do. Just as I was about to kindly excuse myself from the room (hoping that would fix the problem), my CI moved on to the next part of her eval. My CI ended up getting the remaining part of the patient's history later, but I just feel bad that I was the limiting factor.

The line between lingering and learning is so thin. I know I'm in the clinic to follow my CI around and absorb as much information as possible, but sometimes I think it would be better to walk away and give everyone their space.

4 comments

As a fellow DPT student, I will be starting my first clinical soon. So it was great to hear some concerns to expect before the clinical starts. While shadowing therapists, I have experienced the feeling of "tagging along", not wanting to impede on the PT-patient relationship or the patient's therapy, while learning as much as possible. I usually just made sure I had good communication with the PT and patient, so they were comfortable with me shadowing. Before reading your post I was thinking that the same tag along relationship doesn't occur as much in a clinical setting, because the student is there to learn. It does make sense that as a PT student we will still have to balance the "tag along" relationship. I believe your advice of communicating our concerns with the CI is the best approach to handling the situation appropriately. Great communication with the patient is also very helpful with these situations. I am excited for the learning experience and journey soon to begin! Good luck with your PT education and clinicals!

Hallie Strickland, DPT Student

February 1, 2012 11:26 PM

I also am a first year student anxious to start my first clinical in a few weeks. Like most PT students, I did many hours of observation and volunteering before starting graduate school and remember feeling like a lost puppy during evals. At the same time, while observing patients during their treatment sessions, I remember that I often got a chance to stay with the patient while the therapist themself would be co-treating another patient. This allowed for me to engage in conversation with patients and thier responses to treatment a little more than I feel like I might have a chance to after I graduate. In addition to learning about the patients themselves, I felt like I got a birds eye view of exactly what patients may be feeling during thier treatment sessions.

Clayton Self

February 1, 2012 3:58 PM

I was glad to read about this issue. I am a first year DPT student about to go on my first clinical in March and I am definitely nervous about my interaction with my CI. I am hoping that she will help me with the transition from class to the clinic and knowing how to handle different situations that arise with patient care. I was one of many volunteers in the PT rehab department at a hospital during undergrad and had to actively seek out opportunities to help or observe the PTs. I was often ignored by the PTs unless I brought attention to myself. I am hoping that being a DPT student will change this dynamic and I also hope that my lingering presence will not affect my CI's relationship with her patients. I want to experience true interactions between the therapist and the patient and to take note of how the patient responds during evaluation and treatment. Tasha, thank you for the advice about communicating with the CI about any difficulties I may have. I will try to remember that!

Lindsey Cannon

January 23, 2012 9:26 PM

Been there--my best advice is to communicate your concerns with your CI and brainstorm solutions. I'm in my 3rd year and I was just talking to my CI today about directing visits/confidences. I explained that part of my hesitation is having him "approve" my choices and not missing anything obvious. We decided that I'll direct, and simply say "We are going to step out to discuss some options and we'll be back in one minute," to make sure we are on the same page. Hopefully easy enough, but we'll see if it actually works! You have to advocate for your experience. Good luck!

Tasha Parman

January 16, 2012 11:23 PM

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